Inspection on 16/12/05 for Stradbroke Court

This inspection was carried out on 16th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Stradbroke Court 15/10/08

Stradbroke Court 01/11/06

Stradbroke Court 20/04/05

Stradbroke Court 06/10/04

Stradbroke Court 23/04/04

Similar services:

Claremont House

Chesham House

Oak Ridge

Argyll House

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Stradbroke Court Green Drive Lowestoft Suffolk NR33 7JS Lead Inspector John Goodship Announced Inspection 16th December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Stradbroke Court Address Green Drive Lowestoft Suffolk NR33 7JS Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01502 405494 Suffolk County Council Post Vacant Care Home 35 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (25) Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 2 named persons, whose names were made known to the Commission in April 2005, aged 65 years and over, who require care by reason of dementia. 1 named person, whose name was given to the Commission in September 2005, who requires care by reason of mental health 20th April 2005 Date of last inspection Brief Description of the Service: Stradbroke Court is a purpose built home for older people, which was refurbished a few years ago to a high standard. It currently provides 13 residential care places (including 2 short-term care places), 10 special needs places and 12 rehabilitation places. The accommodation is all located on the ground floor and is divided into separate units. A day service is also provided in the building. Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was the second inspection of the current inspection year. The previous inspection took place on 20/04/05. The inspection took 6.25 hours and the manager was present throughout. The inspector toured the home speaking to many residents and some visitors. Pertinent comments are included below. Records and other documents were examined, and part of the lunchtime medication round was observed. There were 10 residents on the special needs unit (Hickling), and 13 people on the residential unit (Trinity). There were 5 people staying in the rehabilitation unit (East Point). During the day, the inspector conducted a fit person interview with the manager as part of her registration process. The outcome of this would be advised to her separately. What the service does well: What has improved since the last inspection? What they could do better: The home must maintain the right of residents to privacy when outside professionals are treating them. Some of the home’s policies do not reflect actual practice in the home. This would not be so if the policies were reviewed regularly. Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 6 Although compliant with medication administration standards, the home should review some aspects of the storage and preparation of medication, and its security in case the person dispensing is called away. The Fire Risk Assessment document may need reviewing to comply with legislation. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,6. Prospective residents have all the information they need, to assess if the home will meet their needs. The home also collects information to ensure it can meet the residents’ needs. The home has different levels of service to meet the needs of people for rehabilitation, dementia and residential care. Needs are carefully assessed and reviewed with the residents and their relatives to ensure that the care is appropriate. Strict guidelines for the use of the rehabilitation unit ensure no one stays longer than the planned period with an agreed programme of rehabilitation, to ensure that people can return home as soon as possible. EVIDENCE: The Statement of Purpose and the Service Users’ Guide had been up dated for the new manager and other staff names and contained all the information required to help prospective residents decide upon the suitability of the home to meet their needs. Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 9 Care plans evidenced that there were proper admission procedures leading to appropriate care planning for each unit. They also included a copy of each person’s contract to live in the home. There were five people in East Point for rehabilitation. They stay for six weeks to prepare them to return home usually with a support package. Staff on this unit were called Enablers to emphasise their role. The unit also had the services of an occupational therapist, who had recently been able to offer advice to the mainstream unit. One person was waiting to return home but could not do so yet as a support package had not been assembled. Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Care plans are comprehensive and regularly reviewed to ensure residents’ current needs are being met, with appropriate use of outside professionals. The procedures for the administration of medicines ensured that residents were properly and safely medicated. A recommendation has been made to review the space available for administration and for quickly securing the medication in an emergency. Staff were observant of the privacy and dignity of residents except in one situation involving a healthcare professional treating a resident. Residents should expect that all consultation and treatments take place in private. EVIDENCE: The care plans for two residents who had been admitted to the home within the previous two months were examined. These showed that the plans were drawn up on admission and were regularly reviewed. They included medical information, records of visits by healthcare professionals, medication reviews and, in one case, a weight record. There were appropriate risk assessments, relating to aspects of daily living, such as smoking, and to aspects of the Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 11 person’s medical condition. There were records of the monthly plan review. A change in the need for a mobility warning device was recorded. Although the information was very comprehensive, there was a summary sheet prepared by each keyworker in the form of a spider diagram for ease of reference by care staff. A District Nurse was dressing the foot of a resident with a pressure area. This was the only resident in the home needing pressure area treatment. In fact the resident could now walk with a frame and with special sheepskin slippers, as was observed. The treatment was taking place in their room. The door was open but it was not clear if this was the wish of the resident. It would normally be expected that such treatment took place in private. The midday drug administration round was followed. Correct procedures were followed. The senior carer ensured that all tablets were taken and then signed for. There were no gaps in the administration record. The drugs were stored on each unit in locked cupboards in the kitchen areas of the dining rooms, either above or below the work surface. The dispensing space was very limited, and at lunchtime the area was busy with staff serving the residents. It was not clear how quickly the medicines could be secured if the need arose. The fridge for medication was in the storeroom. Out of the twelve residents who had died during the past year, seven of them had been able to stay in the home to the end. The manager stated that the home would be guided by the GP’s opinion of the needs of the person for hospital admission, but otherwise the home would assess if staff could care for the person in the home. Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14. The home arranged many of the aspects of daily life around the residents’ wishes, to give them maximum independence and influence over their lifestyle. EVIDENCE: Several residents were able to visit the day centre, which is a part of the building, to join in some of the activities. There was an entertainer performing in the morning with carols and Christmas songs. There was also a hobbies room with a variety of materials for different craft and recreational activities. The results of some craftwork by residents of Hickling unit were displayed on the walls of their dining room. Photos on notice boards in the units recorded special events. There was a reminiscence room with examples of everyday life over the past century. Two residents had for some time been very close, and now wanted to get married. The home had worked with them, and their relatives, to ascertain the wishes of both of them. Their social worker was responsible for taking the legal and other issues forward. Residents who wished to hold their own money were supported to do so and had secure facilities for its storage. Residents could choose when they got up Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 13 and went to bed. Several residents were getting up during the middle of the morning of the inspection. Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. The low level of complaints reflects the home’s standards and its good relationships with residents and their families. The home has shown that it follows the correct procedures to protect residents. EVIDENCE: No complaints had been received by the home or the Commission since the previous inspection. There were many appreciative comments in the visitors’ book. The manager had recently reported to Customer First and the Commission that a sum of money appeared to be missing from the room of a person receiving short-term care. The police had been informed. The person had now returned home. The correct procedure had been followed by the home. Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): As all these standards were inspected and assessed as met at the previous inspection, none were inspected this time. EVIDENCE: Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. The home is appropriately staffed in each unit for the needs of the residents. Staff have good training programmes which maintain their competence. EVIDENCE: There were two vacancies for carers at the time of inspection, with cover being provided by existing staff and occasional agency staff. There were four carers and a team leader on duty throughout the day, with an extra carer during the early morning and the late afternoon. Over half the care staff had achieved NVQ Level 2 or above, and eight more were in the process of being assessed. The personal file for the newest member of staff who started on 28/11/05 was examined. All required identification documents and check documents had been received. There was a training record with the internal induction checklist and record of the moving and handling training. There was a training plan for the year ahead setting out the mandatory refresher training. This would be delivered by the team leaders who were scheduled to attend courses on Food Hygiene, Health and Safety, Fire Safety, Vulnerable Adults, Dementia Care, and Diversity training in January, February and March 2006. In addition all staff would undergo Unisafe training. The Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 17 home would be starting dementia care mapping, which is an observational care tool being rolled out through all County Council homes. The mapping would be undertaken by a trained mapper from another home, and fed back to the care staff. Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34,37,38. Residents are safeguarded by the home being part of the Suffolk County Council Social Care Services, with a full range of care, financial and health and safety policies, procedures and audits. A more regular review of policies would increase the safeguarding of residents’ interests. EVIDENCE: The manager of the home was in the process of being assessed for registration by the Commission for Social Care Inspection. The home had an agreed Business Plan for the current financial year, covering budgets, safeguarding adults, health and safety, workforce planning and development, recruitment, user involvement, quality assurance. The home follows the County Council’s accounting and financial budgeting and control procedures. Those residents who wish to look after their own financial affairs do so. Relatives or legal advisers take that responsibility otherwise. If residents Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 19 wish to keep small amounts of cash with them for everyday needs, they are able to use secure facilities in their rooms. There was evidence that policies had not been reviewed regularly. The policy on continence promotion had been written in May 2002 and was written in very general terms. It did not reflect the actual practice in the home. It did not mention that the home used the Age Concern continence training manual, nor that it received help and advice from the Continence Advisor of the health trust. All residents’ doors were being fitted with automatic door closers which would be able to hold the doors open at any angle required by the resident. All were connected and reported by the manager as working within a week of the inspection. The manager reported that the doors were now lighter and easier for residents to open. A fire drill had taken place in October 2005, when the alarm had been set off. The log recorded that staff had followed the correct procedures. There was a Fire Risk Assessment available. It was only in checklist format, and did not contain all the items recommended by Suffolk Fire and Rescue Service. This information was available in the home but not in a readily accessible form. There had been a visit from the environmental health officer in October 2005 to inspect food hygiene practices. The report stated that “food safety management and practices were of a high standard.” It recommended attention to some flaking paint on the kitchen ceiling, and the need for ventilation. These matters had been submitted by the manager to the Council maintenance service. Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 X X 2 3 Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP10 Regulation 12(4) Requirement Timescale for action 01/01/06 2 OP33 12(1) The registered person must ensure that service user’s privacy and dignity are respected at all times, with particular regard top consultation with healthcare professionals. The registered person must 01/01/06 ensure that policies and procedures are reviewed regularly and not less than annually RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations The manager should review the area available for the preparation and handling of medication on the units, and assess the security of medication if the dispenser is called away. A report should be sent to the Commission. The manager should compare the fire risk assessment with the information required by the fire legislation. 2 OP38 Stradbroke Court DS0000037419.V261321.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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